Provider Demographics
NPI:1831680271
Name:OCHOADA, LALAINE GRACE FABELLA (PT)
Entity Type:Individual
Prefix:
First Name:LALAINE GRACE
Middle Name:FABELLA
Last Name:OCHOADA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LALAINE GRACE
Other - Middle Name:
Other - Last Name:FABELLA-OCHOADA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1011 SOMBRILLO CT
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-3259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1011 SOMBRILLO CT
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-3259
Practice Address - Country:US
Practice Address - Phone:505-662-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist